Provider Demographics
NPI:1194075713
Name:AMEDCO KENTUCKY PLLC
Entity type:Organization
Organization Name:AMEDCO KENTUCKY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:ABELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-373-0300
Mailing Address - Street 1:2350 REGENCY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2351
Mailing Address - Country:US
Mailing Address - Phone:859-373-0300
Mailing Address - Fax:859-373-0024
Practice Address - Street 1:2350 REGENCY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2351
Practice Address - Country:US
Practice Address - Phone:859-373-0300
Practice Address - Fax:859-373-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty